Screening for High Risk Human Papillomavirus Using Passively Self-Collected Menstrual Blood [A91

Abstract

INTRODUCTION: Globally, cervical cancer is the fourth most common women’s cancer, and the second highest cause of cancer-related mortality. High risk human papillomavirus (HR-HPV) testing is a potential primary test but is conventionally clinic-performed. HR-HPV detection via self-collected samples could increase screening access, reducing opportunity costs and uncomfortable visits. A modified menstrual pad (Q-Pad, www.qvin.com/en), offers passive HR-HPV sample collection and is a potential screening approach alternative. It has a removable collection strip, with specimen-processing as dried blood spots. Objectives: 1) to assess Q-Pad vs. clinician-collected HR-HPV concordance 2) assess Q-Pad acceptability. METHODS: Women presenting for either cervical cancer screening or with an HPV-positive history were eligible. Three samples were requested from participants: 1) clinician-collected cervical specimens (CCS) 2) self-collected swabs (SCS), and 3) a Q-Pad which was taken home for use during the next menstruation (QPS). All conventional samples were processed using the Roche Molecular Systems’ Cobas HPV Test. Q-Pad dried blood spots were eluted, then similarly processed. RESULTS: A total of 153 women participated and 107 provided QPS and CCS. Among HR-HPV positive samples where the CCS to QPS interval (Q-Pad use) was CIN2, Q-Pad and CCS agreement was 100%. Thirty percent expressed discomfort with self-swabbing and refused SCS collection. Ninety-four percent recommended Q-Pad over clinician-collected sampling. Twelve percent of patients were Q-pad HPV-positive but CCS negative. CONCLUSION: Among HPV-positive women, the Q-Pad showed highly concordant results (95-100%) compared to clinician-collected sampling. This collection approach shows promise for integration into cervical cancer prevention programs.